417 Sports Medicine And Orthopedics Llc

LBN: 417 Sports Medicine And Orthopedics Llc
417 Sports Medicine And Orthopedics Llc is an health care organization with primary practice located at 3328 S National Ave , Springfield MO 65807-7305. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as the primary health care specialty. 417 Sports Medicine And Orthopedics Llc can be contacted via phone (417) 771-3147, or through Gifford, Eric via phone (817) 825-5096.

Contact Information

Primary practice address
3328 S National Ave Springfield MO 65807-7305
Phone: (417) 771-3147
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Gifford, Eric Doctor of Medicine (MD)
Phone: (817) 825-5096

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X

Profile Details

NPI number 1871105312
LBN Legal business name 417 Sports Medicine And Orthopedics Llc
DBA Doing business as
Authorized official Gifford, Eric Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 17th, 2020
Last updated May 16th, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871105312 NPPES
Other 7860260001 NATIONAL SUPPLIER CLEARING HOUSE

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